Reitsma J B, Kardaun J W, Gevers E, de Bruin A, van der Wal J, Bonsel G J
Academisch Medisch Centrum, afd. Klinische Epidemiologie en Biostatistiek, Postbus 22.660, 1100 DD Amsterdam.
Ned Tijdschr Geneeskd. 2003 Nov 15;147(46):2286-90.
To examine the feasibility of using information from the Dutch Municipal Population Register (Dutch acronym: GBA) to anonymously track groups of patients.
Exploratory.
Using a random sample from the Dutch National Medical Register (Dutch acronym: LMR), hospital admission with discharge in January 1996, it was determined to what extent the admission records could be linked to the GBA. The following variables were used in the linking process: date of birth, gender and the numerical part (4 digits) of the postal code. Once a record had been linked to a single record in the GBA, the pattern of moving and mortality over the next two years was investigated.
Of the 124,598 different hospitalisation records in the LMR cohort, 84% could be linked with a single record in the GBA. In 11% of the patients no unique link was possible: one hospital record could be linked to several records in the GBA. No matching record could be found for 5% of the patients; some of these were foreign citizens resident in the Netherlands. Two years after discharge, the cumulative mortality was 44% for cancer patients, 28% for patients with acute myocardial infarction, 57% for patients with heart failure and 20% for patients with respiratory diseases. Eleven percent of the patients moved within the two-year period following discharge. This would have caused a considerable bias in the aforementioned mortality rates, if the patients' migration had meant that they could no longer be followed.
The introduction of the GBA has significantly increased the possibilities for following patients within and between registries. A prerequisite for this is a unique and correct identification of an individual within the GBA.
研究利用荷兰市政人口登记册(荷兰语缩写:GBA)中的信息对患者群体进行匿名追踪的可行性。
探索性研究。
从荷兰国家医疗登记册(荷兰语缩写:LMR)中选取1996年1月有入院及出院记录的随机样本,确定入院记录与GBA的关联程度。在关联过程中使用了以下变量:出生日期、性别以及邮政编码的数字部分(4位数字)。一旦一条记录与GBA中的一条单一记录建立关联,便对接下来两年内的迁移和死亡率模式展开调查。
在LMR队列中的124,598条不同住院记录里,84%能够与GBA中的一条单一记录建立关联。11%的患者无法建立唯一关联:一条医院记录可能与GBA中的多条记录相关联。5%的患者未找到匹配记录;其中一些是居住在荷兰的外国公民。出院两年后,癌症患者的累积死亡率为44%,急性心肌梗死患者为28%,心力衰竭患者为57%,呼吸系统疾病患者为20%。11%的患者在出院后的两年内迁移。如果患者的迁移意味着无法再对其进行追踪,那么这将对上述死亡率造成相当大的偏差。
GBA的引入显著增加了在登记册内部及之间追踪患者的可能性。前提是在GBA中对个体进行唯一且正确的识别。